The performance of organic photovoltaic devices based upon bulk heterojunction blends of donor and acceptor materials has been shown to be highly dependent on the thin film microstructure. In this tutorial review, we discuss the factors responsible for influencing blend microstructure and how these affect device performance. In particular we discuss how various molecular design approaches can affect the thin film morphology of both the donor and acceptor components, as well as their blend microstructure. We further examine the influence of polymer molecular weight and blend composition upon device performance, and discuss how a variety of processing techniques can be used to control the blend microstructure, leading to improvements in solar cell efficiencies.